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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2007;27:352.)
© 2007 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Serum Amyloid P and Cardiovascular Disease in Older Men and Women

Results from the Cardiovascular Health Study

Nancy Swords Jenny; Alice M. Arnold; Lewis H. Kuller; Russell P. Tracy; Bruce M. Psaty

From the Department of Pathology (N.S.J.), College of Medicine, University of Vermont, Burlington; the Department of Biostatistics (A.M.A.), University of Washington, Seattle; the Department of Epidemiology (L.H.K.), University of Pittsburgh School of Public Health, Pa; the Department of Biochemistry (R.P.T.), University of Vermont, Burlington; and the Departments of Medicine, Epidemiology, and Health Services (B.M.P.), Cardiovascular Health Research Unit, University of Washington, Seattle.

Correspondence to Nancy Swords Jenny, PhD, Department of Pathology, College of Medicine, University of Vermont, 208 South Park Drive, Suite 2, Colchester, VT 05446. E-mail Nancy.Jenny{at}uvm.edu

Objective— Serum amyloid P (SAP), a pentraxin like C-reactive protein (CRP), functions in innate immunity. However, associations of SAP with cardiovascular disease (CVD) are unknown.

Methods and Results— We examined these associations in the Cardiovascular Health Study using a case–cohort design. Nonexclusive case groups were incident angina (n=523), myocardial infarction (MI; n=308), stroke (n=323), and CVD death (n=288). 786 participants had no events. SAP was correlated with CRP, CVD risk factors (obesity, blood pressure, lipids), common and internal carotid wall thickness, and ankle-brachial index (all P<0.02). In Cox regression models adjusted for age, sex, and ethnicity, a standard deviation increase in SAP (9.8 mg/L) was associated with angina (hazard ratio; 95% confidence interval 1.3; 1.2 to 1.5) and MI (1.3; 1.1 to 1.5), but not stroke (1.1; 0.9 to 1.3) or CVD death (1.1; 0.9 to 1.3). Adding CRP to the models had no significant effect on associations. Adjusting for CVD risk factors slightly attenuated SAP associations with CVD events; however, associations with angina and MI remained significant.

Conclusions— Although both are pentraxins, SAP and CRP may represent different facets of inflammation. The association of SAP with CVD in these older adults further supports the role of innate immunity in atherosclerosis.

Serum amyloid P (SAP) is a pentraxin similar to C-reactive protein. We examined the association of SAP with cardiovascular disease (CVD) in older adults. SAP was associated with inflammatory markers, CVD risk factors, measures of subclinical CVD, and incident angina and MI.

Key Words: cardiovascular disease • serum amyloid P • C-reactive protein • elderly • atherosclerosis

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